Evaluation of Urinary Tract Infection in children.

Muthulingam, V (2008) Evaluation of Urinary Tract Infection in children. Masters thesis, Coimbatore Medical College, Coimbatore.


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INTRODUCTION : Controversy continues to exist regarding when and how a child with urinary tract infection should be evaluated. Urinary tract infections are common at the extremes of age - in children and elderly. Symptoms of urinary tract infections are vague and generalized1. Recognition and evaluation of urinary tract infection and genitourinary anomalies associated with the infection and subsequent management prevents long term complications of progressive parenchymal and functional loss. In infants UTI is the most common cause of parenchymal loss. 5% to 10% of children with UTI have obstructive urinary tract infection and an additional 21% to 57% have vesicoureteric reflux2. Children with voiding dysfunction, neurogenic bladder, bowel dysfunction have associated urinary tract infections3,4. Hence evaluation of the index infection may be worth evaluating to detect anomalies in the urinary tract and helps in prevention of morbidity of recurrent infections and renal damage. AIMS : 1. To detect the abnormalities of the urinary tract associated with urinary tract infection in children. 2. To find out the most common organism associated with urinary tract infection. 3. To find out the most useful drug in treating UTI. 4. To evaluate the yield of the various diagnostic modalities. MATERIALS AND METHODS : After approval from the Ethical committee and permission from the collaborating departments of this institution, the prospective study on evaluation of urinary tract infection in children was conducted at Coimbatore Medical College Hospital. Period of study : The period of study was from March 2006 to March 2008. The study was carried out at the Department of Paediatric Surgery in collaboration with Departments of Microbiology and Radiodiagnosis. Study design : The children who reported at or were referred to our out patient department with symptoms and signs of urinary tract infection were evaluated with urine culture. Children with positive urine culture were included in the study and further evaluated with ultrasonogram (USG) of kidney and bladder. The urinary tract infection is treated with appropriate antibiotics as dictated by antibiogram. Once the urine culture became negative, these children were subjected to voiding cystourethrogram with antibiotic prophylaxis. Cystocopy, renal scintigrapy, urodynamic study and other relevant investigations were performed based on the individual merits of the condition. The results were compiled and analysed. CONCLUSION : 1. Twenty nine percent of the UTIs are associated with genitourinary anomalies hence it is worth evaluating the child with UTI. 2. Vesicoureteic reflux is the commonest anomaly associated with UTI. 3. E.coli is the commonest organism causing UTI. 4. Voiding cystourethrogram is the tool for the diagnosis of VUR and PUV. 5. It is reasonable to approach a UTI with VCUG and if it is necessary an USG to rule out other anomalies. 6. Amikacin may be useful for empirical treatment for UTI in our children. 7. Since the study is conducted on a select and small population it needs further study.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Urinary Tract Infection ; children ; Evaluation.
Subjects: MEDICAL > Paediatric Surgery
Depositing User: Kambaraman B
Date Deposited: 31 Jul 2017 04:10
Last Modified: 31 Jul 2017 04:10
URI: http://repository-tnmgrmu.ac.in/id/eprint/2363

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